From the Guidelines
Night sweats in men can be caused by low testosterone levels, among other factors, and evaluating testosterone levels is essential in patients with signs and symptoms of hypogonadism, including night sweats 1.
Causes of Nocturnal Hyperhidrosis
The causes of nocturnal hyperhidrosis, or night sweats, in males can be varied and complex. Some possible causes include:
- Hormonal disorders, such as low testosterone or hyperthyroidism
- Infections, like tuberculosis or HIV
- Certain cancers, particularly lymphoma
- Medication side effects, including antidepressants, fever reducers, and diabetes medications
- Anxiety disorders
- Environmental factors, such as an overly warm bedroom or heavy bedding
Importance of Testosterone Evaluation
According to the study published in Gastroenterology in 2017 1, testosterone deficiency in males is associated with various health issues, including energy imbalance, impaired glucose control, and reduced insulin sensitivity. The study suggests that evaluating testosterone levels is crucial in patients with signs and symptoms of hypogonadism, including decreases in energy, libido, muscle mass, and body hair, as well as hot flashes, gynecomastia, and infertility.
Diagnostic Approach
To diagnose the cause of night sweats, a physician may recommend blood tests to check hormone levels, infection markers, or other indicators depending on the symptoms. The study recommends measuring morning total testosterone concentration, free testosterone level by equilibrium dialysis, and sex hormone-binding globulin level in patients with obesity 1.
Treatment
Treatment for night sweats will depend on the underlying cause. If low testosterone levels are identified as the cause, testosterone replacement therapy may be considered. The study suggests that transdermal testosterone preparations are a convenient and effective option for most hypogonadal men, but the method of testosterone replacement should be individualized for each patient 1.
From the Research
Causes of Nocturnal Hyperhidrosis in Males
The causes of nocturnal hyperhidrosis (night sweats) in males can be attributed to various factors, including:
- Medications: Selective serotonin reuptake inhibitors (SSRIs) have been associated with night sweats in older patients 2. Angiotensin receptor blockers (ARBs) and thyroid hormone supplements have also been linked to night sweats 2.
- Infections: Pertussis, also known as whooping cough, can cause sweating attacks, including night sweats, in adults 3.
- Hormonal changes: Although the provided studies primarily focus on female populations, hormonal fluctuations can contribute to night sweats in males as well.
- Lifestyle factors: While not directly addressed in the provided studies, lifestyle factors such as smoking, high-risk drinking, and weight gain may contribute to night sweats in males, as they have been linked to night sweats in females 4.
Medication-Induced Night Sweats
Medications, particularly SSRIs, can cause night sweats in males. A study found that SSRIs were associated with night sweats in older patients, with an odds ratio of 3.01 2. Another study reported a case of a reproductive-aged woman experiencing night sweats and elevated follicle-stimulating hormone levels while taking SSRIs for depression 5.
Infection-Related Night Sweats
Pertussis, a highly contagious respiratory illness, can cause night sweats in adults, including males. A study found that 14% of adults with pertussis experienced sweating attacks, including night sweats 3.
Limitations and Future Research
The provided studies have limitations, including a primary focus on female populations and a lack of direct evidence on the causes of nocturnal hyperhidrosis in males. Further research is needed to fully understand the causes of night sweats in males and to develop effective treatments.